Acute Kidney Injury and Bronchopulmonary Dysplasia in Premature Neonates Born Less than 32 Weeks' Gestation

Michelle C. Starr, Louis Boohaker, Laurie C. Eldredge, Shina Menon, Russell Griffin, Dennis E. Mayock, Linzi Li, David Askenazi, Sangeeta Hingorani, Namasivayam Ambalavanan, David T. Selewski, Subrata Sarkar, Alison Kent, Jeffery Fletcher, Carolyn L. Abitbol, Marissa Defreitas, Shahnaz Duara, Jennifer R. Charlton, Jonathan R. Swanson, Ronnie GuilletCarl D'Angio, Ayesa Mian, Erin Rademacher, Maroun J. Mhanna, Rupesh Raina, Deepak Kumar, Jennifer G. Jetton, Patrick D. Brophy, Tarah T. Colaizy, Jonathan M. Klein, Ayse Akcan Arikan, Christopher J. Rhee, Stuart L. Goldstein, Amy T. Nathan, Juan C. Kupferman, Alok Bhutada, Shantanu Rastogi, Elizabeth Bonachea, John Mahan, F. Sessions Cole, T. Keefe Davis, Joshua Dower, Lawrence Milner, Alexandra Smith, Mamta Fuloria, Kimberly Reidy, Frederick J. Kaskel, Danielle E. Soranno, Jason Gien, Katja M. Gist, Aftab S. Chishti, Mina H. Hanna, Craig S. Wong, Catherine Joseph, Tara Dupont, Robin Ohls, Amy Staples, Surender Khokhar, Sofia Perazzo, Patricio E. Ray, Mary Revenis, Sidharth K. Sethi, Smriri Rohatgi, Cherry Mammen, Anne Synnes, Sanjay Wazir, Pia Wintermark, Robert Woroniecki, Shanty Sridhar, Susan Ingraham, Arwa Nada, Michael Zappitelli

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Objective This study aimed to evaluate the association between acute kidney injury (AKI) and bronchopulmonary dysplasia (BPD) in infants born <32 weeks of gestational age (GA). Study Design Present study is a secondary analysis of premature infants born at <32 weeks of GA in the Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) retrospective cohort (n = 546). We stratified by gestational age and used logistic regression to determine association between AKI and moderate or severe BPD/mortality. Results Moderate or severe BPD occurred in 214 of 546 (39%) infants, while death occurred in 32 of 546 (6%); the composite of moderate or severe BPD/death occurred in 246 of 546 (45%). For infants born ≤29 weeks of gestation, the adjusted odds ratio (OR) of AKI and the primary outcome was 1.15 (95% confidence interval [CI] = 0.47-2.86; p = 0.76). Infants born between 29 and 32 weeks of gestation with AKI had four-fold higher odds of moderate or severe BPD/death that remained after controlling for multiple factors (adjusted OR = 4.21, 95% CI: 2.07-8.61; p < 0.001). Conclusion Neonates born between 29 and 32 weeks who develop AKI had a higher likelihood of moderate or severe BPD/death than those without AKI. Further studies are needed to validate our findings and evaluate mechanisms of multiorgan injury.

Original languageEnglish (US)
Pages (from-to)341-348
Number of pages8
JournalAmerican Journal of Perinatology
Issue number3
StatePublished - Feb 1 2020


  • acute lung injury
  • acute renal failure
  • bronchopulmonary dysplasia
  • chronic lung disease
  • neonate
  • organ crosstalk
  • prematurity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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